POS0601-HPR DOING EVERYTHING POSSIBLE TO PRIORITIZE WORK: LIVED WORK EXPERIENCE OF YOUNG ADULTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: M. Golding, F. Nishat, K. Merrill, R. Kaur, J. Stinson, J. Protudjer, R. Woodgate, C. Peschken, D. Lacaille, U. Oguzoglo, Z. Touma, L. Lim
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Young adulthood (18-30 years) is a critical life-stage when individuals launch into independence, establishing employment. Failure to establish employment during young adulthood is associated with reduced lifetime socioeconomic achievement. A few studies focused on studying employment outcomes in young adults with systemic lupus erythematosus (YASLE) showed less full-time work than general population, substantial absenteeism and productivity loss. Studying the lived work experience of YASLE can broaden our understanding in this area from the patients' perspectives. <h3>Objectives</h3> To describe the early work experiences of YASLE and explore their perceptions of SLE influences on their work. <h3>Methods</h3> This was a qualitative descriptive study. Young adults with childhood- or adult onset SLE were recruited from 2 adult rheumatology clinics (Oct 2021-Aug 2022) in Manitoba and Ontario. Inclusion criteria: YASLE who were employed, unemployed (looking for work or not), or work disabled. Potential participants were purposely sampled for diversity in: sex/gender, age of onset, major organ disease, occupation groups. All completed a pre-interview questionnaire to provide demographic, SLE and work-related information. Semi-structured interviews were conducted individually via video conference, focusing on their work experiences, future aspirations and perceived SLE influences. Interviews were audio-recorded, transcribed verbatim and analyzed using a reflexive thematic analysis. <h3>Results</h3> Of 18 participants, 13 identified as females, 1 as non-binary; median age 25 (22- 29, 25-75<sup>th</sup> percentile) years. Participants' identified ethnicities: 7/18 Asian, 5/18 White, 2/18 Indigenous, 4/18 other. 7/18 were childhood-onset SLE, 9/18 had major organ disease. 12/18 were employed full-time, 3/18 unemployed/ looking for work, 3/18 unemployed/ not looking to work. 6/18 worked in managerial/ professional jobs. Three have current work accommodations, 2/3 for SLE. 13/18 report highest education to be university/ postgraduate. Most participants perceived themselves to be functioning relatively well at work despite modest physical, cognitive limitations. Two main themes emerged: 1) "Getting by, with some help" describes many factors that participants cited as critical in helping them stay in the workforce. Most of the factors mapped to the underlying construct of control over their work. Participants who have the flexibility to manage their time, physical positions and environment perceived fewer issues staying in work Participants also reported increasing recognition (over time) of the importance of medication adherence in disease control, which helped them to stay in work. Other frequently cited facilitators also included sedentary jobs and the availability of social support. 2) "Tough choices: work or health over everything else" describes how participants struggled to find a balance between their health, work and social life. Many described multiple strategies to prioritize work while trying to preserve their health: rest more, avoid commute, avoid stress, help or transfer responsibility for chores, limiting social activities. A few however deemed the costs of work to be too great and chose to prioritize their health by avoiding work altogether. <h3>Conclusion</h3> Most YASLE report being employed and setting a high priority on work. They recognized the importance of their health in helping them to work. They diverted considerable energy/ resources from other aspects of life to maintain work. This begs the question of whether this approach could be sustainable beyond this life stage. However, this work on YASLE patients also identified multiple potential targets of interventions to help them continue working. By focusing on young adulthood, this will ensure that our strategies will be most appropriate for their life-stage, maximizing impacts. <h3>References</h3> [1]Jetha A, et al. Arthritis care &amp; research. 2015;67:1246-54. [2]E. F Lawson, et al. Arthritis Care Res 2014; 66: 717-24. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Mike Golding: None declared, Fareha Nishat: None declared, Kaitlyn Merrill: None declared, Ramandeep Kaur: None declared, Jennifer Stinson: None declared, Jennifer Protudjer Speakers bureau: Nutricia (Food allergy university, Nov 2022), Consultant of: Novartis 2021, allergy related, Roberta Woodgate: None declared, Christine Peschken Paid instructor for: For GSK and Astra Zeneca. Not related to this abstract.&lt; $5000., Diane Lacaille: None declared, Umut Oguzoglo: None declared, Zahi Touma: None declared, Lily Lim Speakers bureau: Pfizer Feb 2023, unrelated to this abstract, &lt;$5000.